Bonita Babcock (right) looks on as a physician assistant at the clinic in King Cove, Alaska, explains to Interior Secretary Sally Jewell how a road from King Cove to Cold Bay would improve health care.

Annie Feidt
/ Alaska Public Radio Network

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Originally published on September 13, 2013 6:29 pm

The town of King Cove, Alaska, is crowded onto a narrow spit, surrounded by ocean and isolated by rows of volcanic mountains.

It's an Aleut Native community of about a thousand people, and for roughly a third of the year, treacherous winds close its airstrip. There's no road between King Cove and Cold Bay, the nearest town with year-round air facilities. When the weather turns bad, the only way out of King Cove is a two-hour boat trip through choppy seas.

When there's a call about a medical emergency in the middle of the night, the first thing Bonita Babcock wants to know is how bad the wind is blowing. Babcock is a community health aide and a lifelong resident of King Cove. Her job is to stabilize patients and get them to Cold Bay, so they can be flown 600 miles to the nearest hospital in Anchorage.

"We're looking, and most of the time it's going to have to be a medevac. And we're wondering: What are we looking at here? Are they going to be able to get them out?" Babcock says.

King Cove has been asking for a road to Cold Bay for these types of situations for more than two decades. The U.S. Fish and Wildlife Service has denied the request twice.

Alaska Sen. Lisa Murkowski, a Republican, threatened to hold up Interior Secretary Sally Jewell's confirmation until she agreed to visit King Cove.

Jewell made the trip at the end of August, and Babcock gave her a tour around the King Cove Clinic.

Jewell heard stories of medical close calls, like a baby who was having trouble breathing and had to be rescued by a Coast Guard helicopter. And she heard about unreliable transportation out of and into the community.

Babcock told Jewell that the clinic sometimes has to make do without essential medicines. "Last week, six days it sat in Cold Bay, you know, one of our patient's meds," Babcock told Jewell.

Environmental groups say a road deal for King Cove would set a precedent that could make it easier to build roads through other wilderness areas. Nicole Whittington-Evans, with The Wilderness Society, says Izembek is important for bird species like black brant and tundra swan.

"When you are in Izembek, and you look around at the breathtaking coastal mountains and this incredibly vibrant and ecologically rich area, you know this is a global resource we should be protecting," she says.

Whittington-Evans doesn't think the road is worth it. It would take more than two hours to drive the full 30 miles, and she's skeptical it would be the fastest way to evacuate people with medical emergencies.

King Cove residents acknowledge they want the road for more than health and safety reasons. It would make it cheaper to fly to Anchorage, and high school sports teams could more reliably compete against other villages.

The refuge covers 300,000 acres, and the community and the state are offering to add 60,000 more in exchange for the road.

The decision ultimately rests with Jewell, and she said it's a tough call. "I think that there have been efforts to talk about a tradeoff between human safety and wildlife, and the reality is I think we want both, so I understand the interests on both sides. It's difficult, and I don't think that's a reasonable tradeoff."

She hasn't said when she'll decide. But Etta Kuzakin, with the Agdaagux Tribal Council in King Cove, hopes Jewell's visit persuaded her to approve it.

"It's easy to say no when you see it in writing on paper," says Kuzakin. "But it's not easy to say no when you see, and, you know, and you look at the eyes of the people who have been through these tragic situations."

Five months ago, Kuzakin went into premature labor in King Cove when the winds were howling. She made it out of the community later that day on a Coast Guard helicopter. She now has a healthy daughter named Sunny Ray, but Kuzakin worries about future emergencies that might not end happily.

This piece is part of a partnership among NPR, Alaska Public Radio Network and Kaiser Health News.

The small town of King Cove, Alaska, is in a fight with the U.S. Fish and Wildlife Service. Residents there want a road to the nearest town 11 miles away. But the road would cut through the Izembek National Wildlife Refuge, and environmental groups are opposing it. So it's up to Secretary of the Interior Sally Jewell to decide whether or not it gets constructed.

Alaska Public Radio Network's Annie Feidt traveled with Secretary Jewell when she recently toured the town.

ANNIE FEIDT, BYLINE: When an emergency call wakes up Bonita Babcock in the middle of the night, she immediately checks the weather.

BONITA BABCOCK: How bad is it blowing?

FEIDT: Babcock is a community health aide and a lifelong resident of King Cove, Alaska. The Aleut Native community of about a thousand people is crowded on to a narrow spit, surrounded by ocean and volcanic mountains. Babcock helps stabilize patients and then gets them ready to fly to the nearest hospital in Anchorage, 600 miles away.

BABCOCK: We're looking and it's like, OK, most of the time, it going to have to be a medevac. And we're wondering, what are we looking at here? Are they going to be able to get them out?

FEIDT: About a third of the time, the answer is no. High winds frequently shut down King Cove's small, gravel air strip. 30 miles away, the town of Cold Bay has an all-weather airport, but there's no road between the communities. So King Cove residents have to take a two-hour boat ride in choppy seas to reach Cold Bay when flying isn't an option. King Cove has been asking for a road for more than two decades. And the U.S. Fish and Wildlife Service has denied the request twice. Alaska Senator Lisa Murkowski threatened to hold up Interior Secretary Sally Jewell's confirmation until she agreed to a visit.

SECRETARY SALLY JEWELL: Hello.

MAYOR STANLEY MACK: Secretary Sally Jewell, welcome to King Cove.

JEWELL: Yeah.

MACK: Mayor of King Cove. Glad you're here.

JEWELL: Mayor, very nice to meet you.

MACK: Glad you're here.

FEIDT: With the mayor following along, Babcock gave Jewell a tour of the King Cove Clinic.

UNIDENTIFIED MAN: Follow Bonita.

JEWELL: OK.

FEIDT: Jewell heard stories of medical close calls, like a baby who was having trouble breathing and had to be rescued by a Coast Guard helicopter. And she heard about unreliable transportation out of or into the community. Babcock told Jewell the clinic sometimes has to make do without essential medication.

BABCOCK: Last week, six days it sat in Cold Bay, one of our patient's meds, you know, and...

JEWELL: And there's no boats running back and forth?

BABCOCK: Well...

MACK: The postmaster would have to go over by boat.

JEWELL: I see.

MACK: They've only done that maybe once, and it was a mess. So...

FEIDT: But the 11 mile one-lane gravel road that could make life safer in King Cove would slice through the center of Izembek National Wildlife Refuge. It's 300,000 acres, and the community and the state are offering to add 60,000 more in exchange for the road. But environmental groups say the deal would set a precedent that could make it easier to build roads through other wilderness areas. Nicole Whittington-Evans, with The Wilderness Society, says Izembek is important for bird species like black brant and tundra swan.

NICOLE WHITTINGTON-EVANS: When you are in Izembek and you look around at the breathtaking coastal mountains and this incredibly vibrant and ecologically rich area, you know it is a global resource we should be protecting.

FEIDT: Wittington-Evans says the road isn't worth it. It would take more than two hours to drive the full 30 miles, and she's skeptical it would be the fastest way to evacuate people with medical emergencies. King Cove residents acknowledge they want the road for more than health and safety reasons. It would make it cheaper to fly to Anchorage, and high school sports teams could more reliably compete against other villages. Secretary Jewell says it will be a tough decision.

JEWELL: I think that there have been efforts to talk about a tradeoff between human safety and wildlife, and the reality is I think we want both. And so, you know, I understand the interests on both sides, difficult, and I don't think that that's a reasonable tradeoff.

FEIDT: Jewell hasn't said when she'll make a decision. But Etta Kuzakin, with the Agdaadux Tribal Council in King Cove, is hopeful Jewell will come out in favor of the road.

ETTA KUZAKIN: It's easy to say no when you see it in writing on paper. But it's not easy to say no when you look at the eyes of the people that have been through these tragic situations.

FEIDT: Five months ago, Kuzakin went into premature labor in King Cove when the winds were howling. She made it out of the community later that day on a Coast Guard helicopter. She has a healthy daughter now named Sunny Ray, but she worries about future emergencies that may not have a similarly happy ending. For NPR news, I'm Annie Feidt.

CORNISH: This piece is part of a collaboration with NPR, Alaska Public Radio Network, and Kaiser Health News. Transcript provided by NPR, Copyright NPR.